Q:

4/26/2013
We are training a new nurse in our allergy office. The nurse wants to recap her allergy syringes before administering the allergy injections right after drawing them up. Our syringes have attached needles. We are afraid that she could accidentally prick herself with the needles or contaminate the needles as she is recapping them. Presently, we draw up the reagents and put the syringe on the chart without having the needle touch the chart or we transfer the syringes to a tray just before administration. We all dispose of the syringes properly into a red protec box without recapping. Should we be worried about her recapping the allergy syringes before administration? Thank you for your consideration.

A:

Thank you for your inquiry.

In general, recapping syringes is not a wise procedure. Here is the link to the OSHA recommendations. However, as you can see, these recommendations refer to used syringes, and it is of course debatable whether or not you would consider the syringe simply used to draw up an extract as “used” or “contaminated.”

However, a very practical way to solve your problem would be for you to employ safety syringes. As soon as the extract is drawn up into the syringe, a sheath is drawn over the needle. This would prevent the needle from being contaminated by lying on a surface, and also would not permit recapping. Safety syringes can be purchased, and they are suggested for use in allergen skin testing and immunotherapy. We only employ safety syringes in our office.

In addition, the other way to solve your problem would be to take the extract into the room and draw it into the syringe at the time of the testing. We also do this rather than predraw and take a filled syringe into the room.

In summary, I would make a minimal suggestion of using the safety syringe for all of your procedures, and secondarily it would also be easy for you to draw extract up in the room where the patient is tested. We do this universally.

Thank you again for your inquiry and we hope this response is helpful to you.

1910.1030(e)(2)(ii)(J)

Hypodermic needles and syringes shall be used only for parenteral injection and aspiration of fluids from laboratory animals and diaphragm bottles. Only needle-locking syringes or disposable syringe-needle units (i.e., the needle is integral to the syringe) shall be used for the injection or aspiration of other potentially infectious materials. Extreme caution shall be used when handling needles and syringes. A needle shall not be bent, sheared, replaced in the sheath or guard, or removed from the syringe following use. The needle and syringe shall be promptly placed in a puncture-resistant container and autoclaved or decontaminated before reuse or disposal.

Sincerely,
Phil Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology